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Manufacturing fake doctors

The country’s medical education system is infested by corrupt investors with political protection

Ramu Sapkota

GOPEN RAI

The registration of medical colleges is a convoluted process in Nepal, but it can be made much simpler by bribing a thoroughly corrupt system. Our investigation has revealed a chilling truth: almost everything is for sale in Nepal’s medical education. Nearly everyone is on the take: government ministries, the Nepal Medical Council (NMC), even the anti-corruption watchdog, the CIAA, and Supreme Court.

Anyone can be a doctor if you pay someone enough. Bribery is standard operating procedure in acquiring college licenses, student seats, manipulating monitoring teams, influencing the judiciary. The medical mafia will even guarantee that students with cash will pass not just their entrance exams but their final exams too.

It is because he has seen this ugly underside of medical education that Govinda KC has been on a fast-unto-death so often. His last 13-day hunger strike ended on Sunday after the government assured him that it would clean up the health care sector, but most experts say he may have to fast again because the promises ring hollow.

Every time the Institute of Medicine (IoM) and universities publish entrance exam notices, colleges go to the courts to get a stay order to allow admission of Indian students. Mysteriously, the courts always rule in favour of the medical colleges. We posed as students and secretly recorded an interview with Dhruba Poudel of Universal Medical College, who boasted that he had connections with top judges and can win any case.

“No matter how weak students are, it is my responsibility to ensure they clear the tests, we just need the money. Everything will be taken care of,” he told us, even hinting that he had bribed a certain bearded Chief Justice in the past (see box).

The vicious web of corruption begins after the investor with political protection applies for affiliation with some university. The Nepal Medical Council (NMC) inspects the new college to see if it has adequate infrastructure. Most medical colleges established in the past decade do not meet the minimum criteria. But the investors often ‘influence’ the Ministry of Education and the Ministry of Health and Population and various universities to get their permission.

In 2010 an expert committee found that the College of Medical Sciences in Bharatpur and Nobel Medical College in Biratnagar lacked adequate infrastructure and faculties. The NMC had provided a false report based on which the colleges were handed affiliation letters. Five years later, nothing has changed.

Determining the number of student seats for medical colleges is another task for which money changes hands. The NMC is supposed to monitor medical colleges to determine how many students they can take depending on the facilities. Colleges were found to have bribed the NMC and showed fake infrastructure and faculties. As a result, understaffed and ill-equipped medical colleges have mushroomed across the country, producing underqualified doctors and putting millions of lives at risk.

Baburam Marasini, a senior epidemiologist and former registrar at the NMC says: “The government has set clear guidelines but they have not been followed.”

Our investigation also found that surprise inspections are often leaked to colleges, which then fill hospital beds with fake patients and temporary faculty hired overnight to meet the requirements.

Niranjan Kumar Yadav, a recruiter, admitted bringing 52 such faculty members from India for a Nobel Medical College inspection last month. Private medical colleges make up to Rs 10 billion every year. With that kind of money, colleges lobby hard among decision makers offering huge financial incentives to maximise the number of seats while relaxing the criteria to run the MBBS program. It was the result of this intense lobbying, in 2013 NMC reduced the required number of beds in hospital for every student from 7 to 5.5.

Even the anti-graft body like the CIAA has been meddling in the council’s affairs in determining seat numbers. In one letter dated 15 August 2014 about the proposed accreditations to Birat Medical College and Devdaha Medical College, and another on 1 December 2013 regarding the number of allocated seats for various colleges, the CIAA cleared the number of student seats on offer. The owner of Birat Medical College is a close family member of CIAA chief Lokman Singh Karki.

Jyoti Baniya served as an NMC member and says he was against this arbitrary CIAA decision. He told us: “There were no clear grounds on which the number of seats were increased in Gwarko’s KIST Medical College.” Baniya found out that the NMC was taking instructions from the CIAA secretariat and when he questioned it, the CIAA filed a corruption charge against him.

It turns out that the owner of KIST, Balman Singh Karki is also the brother of CIAA chief Lokman Singh Karki.
On 17 September 2014, an investigation committee set up by Health Ministry showed serious irregularities by the NMC on seat allocations. Over the years, owners of medical colleges have invested huge sums of money lobbying to broaden the criteria set by the council. An official from a private college admitted to us they had to bribe health secretary Pravin Mishra and council chairman Damodar Gajurel to lobby for it.

The student admission process is another area of medical education with entrenched corruption. MB Kedia Dental College in Birganj, Kantipur Dental College in Kathmandu, and Universal Medical College in Bhairawa have all been taking donations for admitting foreign students without qualifying exams. In some cases, Nepali students have also been admitted as Indians to avoid the entrance examinations.

Satish Kumar Deo, who was head of NMC’s ethical committee confirms: “We found many Indians and some Nepali students were admitted without sitting for entrance exams.” Of the 19 students admitted to Kedia Dental College, 14 have already received practicing license from NMC.

A Centre for Investigative Journalism reporter posing as an agent who could bring Indian students to his college interviewed Dhruba Poudel of the Universal Medical College in Bhairawa and secretly recorded his conversation. Excerpts:

“We collected Rs 1.5 million from each medical college to bribe NMC officials to relax the MBBS program criteria. We also had to give Rs 300,000 to health secretary Pravin Mishra apart from the NMC officials. Our Managing Director Khumal Aryal personally dealt with him.”

“We also have connections in the courts, and we can use them to win any case against us. There was a case in the appellate court against the number of student seats that the NMC granted to us. A joint bench of justices Gopal Parajuli and Om Prakash Parajuli dismissed that case.
(Khum) Aryal had a ‘setting’ with justice Gopal Parajuli through Kalu, the real estate broker. (Justice) Parajuli never hands down a ruling against us. We have to manipulate a ‘setting’ with the court’s registrar, and he always refers our case to Parajuli’s bench.”

“I do not know if things have changed after Kalyan Shrestha became Chief Justice, but our lawyers tell me that it is still the same. They can fix everything.

Besides, (Justice) Parajuli is always there to help us. (Justice) Cholendra (Samsher JBR) is even more supportive. Even the bearded Chief Justice (Damodar Neupane) had helped settle a case against us. We gave him Rs 20 million in cash. He personally received the money.”